• Based on data relating to the first large-scale PFI contract termination, we examine the costs and benefits of this approach and the extent to which it can be replicated by other Trusts. • Having already paid £67m over 10 years for the use of a hospital with a capital value of £54m, further payments of £114.2m were made to the SPV to bring the PFI contract to an end. Nonetheless, the Trust expects the termination to secure significant long-term savings. • As terminations will often require large additional expenditures in the short term, Trusts under the most serious financial pressures are the least likely to undertake this approach. • Dealing with the problem of PFI payments is likely to require a co-ordinated central government response, to ensure that that Trusts are reimbursed for their related costs.